History

The patient often presents with an acute onset of abdominal pain, typically during strenuous physical activity, such as exercise or sexual intercourse. Given that follicular cyst rupture is more common than corpus luteal cyst rupture, the onset tends to be midcycle. Other associated symptoms include the following:

Vaginal bleeding

Nausea and/or vomiting

Weakness

Syncope

Shoulder tenderness

Circulatory collapse

Next:

Physical Examination

Vital signs are usually within normal range. Physical findings can range from mild unilateral low abdominal tenderness to those of an acute abdomen with severe tenderness, guarding, rebound, and peritoneal signs.
[7]

Low-grade fever is sometimes observed, and an adnexal mass may be palpable, although absence of such findings on examination has no diagnostic value as many cysts decompress after rupture. Orthostatic changes are consistent with a sizable hemorrhage.